Tang Kai, Zhang Yong-Bao, Fang Jie, Shi Tao, Shen Chen-Yang
Department of Cardiovascular Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Peking, China.
J Surg Case Rep. 2023 Feb 6;2023(2):rjac576. doi: 10.1093/jscr/rjac576. eCollection 2023 Feb.
Iatrogenic arteriovenous fistula (IAVF) is an unusual and potentially fatal complication of lumbar spinal surgery. A 62-year-old patient presented with a history of dyspnea, left lower limb edema and coughing. A physical exam showed bilateral basal rales in the lungs, abdominal bruit and bilateral lower limb pitting edema. A computed tomography angiograph revealed an arteriovenous communication between the right internal iliac artery and the left common iliac vein. The patient was diagnosed with an IAVF, which developed post-lumbar disc surgery. The patient underwent a successful endovascular treatment by using covered stent at the common iliac artery with embolism of lumbar artery. The patient's symptoms were relieved 2 months after surgery.
医源性动静脉瘘(IAVF)是腰椎手术一种罕见且可能致命的并发症。一名62岁患者,有呼吸困难、左下肢水肿及咳嗽病史。体格检查发现双肺底部啰音、腹部杂音及双下肢凹陷性水肿。计算机断层血管造影显示右髂内动脉与左髂总静脉之间存在动静脉交通。该患者被诊断为腰椎间盘手术后发生的医源性动静脉瘘。患者在髂总动脉处使用覆膜支架并栓塞腰动脉,成功接受了血管内治疗。术后2个月患者症状缓解。